| NPI | 1619548617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026763) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 26763) |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: NY 389007) | |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2023-07-07 |