| NPI | 1851858765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 023332) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023332-1) |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2024-04-23 |