| NPI | 1689315095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009436) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 028204) |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2024-11-20 |