| NPI | 1821368291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015512) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2019-07-18 |