| NPI | 1861098733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 029322) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9112946) |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2023-01-31 |