| NPI | 1801405725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA100192) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025380) |
| 363A00000X Physician Assistant (Licence: NY 25380) | |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2024-04-04 |