| NPI | 1831676444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025026) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060032) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2020-06-10 |