| NPI | 1841032232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 03917-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA100825) |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2024-07-10 |