| NPI | 1558743716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 018683) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA 52555) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2021-11-19 |