| NPI | 1861229791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032664) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA065946) |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2024-09-29 |