| NPI | 1568988061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 021167) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 02116701) |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2023-02-15 |