| NPI | 1689129686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 019801) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 19801) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2023-06-30 |