| NPI | 1659732428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021016-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53274) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2022-03-29 |