| NPI | 1841522562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 003022) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 003022) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2019-12-03 |