| NPI | 1669077202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008504) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025708-01) |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2025-01-06 |