| NPI | 1639757289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026654) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 1764) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2022-09-29 |