| NPI | 1750937488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026159) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 57101) |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2021-09-20 |