| NPI | 1720463474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 23018891) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 018891) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2022-03-15 |