| NPI | 1649902206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 28826) |
| 363A00000X Physician Assistant (Licence: NY 028826) | |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2023-07-17 |