| NPI | 1679161673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 030081-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7239) |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2023-10-06 |