| NPI | 1588064174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 017869-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA066269) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2025-04-09 |