| NPI | 1821613910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025129) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 1158586) |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2022-01-27 |