| NPI | 1689397747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 029234) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 1104310440) |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2023-09-18 |