| NPI | 1578970570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 017751) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 17751) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2023-07-03 |