| NPI | 1851583256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011946) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 11946) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2023-07-03 |