| NPI | 1881237576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 029559) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 029559) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2023-03-06 |