| NPI | 1790326262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024546) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2019-12-20 |