| NPI | 1750706990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017408) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 17408) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2023-03-21 |