| NPI | 1720631500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 023693) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23693) |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2023-07-03 |