| NPI | 1669985578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019791) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 19791) |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2023-07-03 |