| NPI | 1629587894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 021405) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021405) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2024-09-17 |