| NPI | 1861034969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7078) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024246) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2022-11-02 |