| NPI | 1669875845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 23018078) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 18078) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2023-04-28 |