| NPI | 1619588076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 025518) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 015136) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 025518) | |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2021-07-13 |