| NPI | 1710490487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021636) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2020-11-24 |