| NPI | 1700210663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 016377) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0163771) |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2022-02-14 |