| NPI | 1598349029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062502) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026602) |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2024-03-14 |