| NPI | 1760849244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 028032) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06233) |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2023-05-11 |