| NPI | 1851771778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 006134-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA002582L) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2021-08-04 |