| NPI | 1669858759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 018906) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 18906) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2023-06-29 |