| NPI | 1760203152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 033022) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9119477) |
| Enumeration Date | 2024-10-18 |
| Last Update Date | 2025-02-17 |