| NPI | 1700356557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 028351-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4676) |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2022-10-23 |