| NPI | 1881267011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA100202) |
| Enumeration Date | 2021-07-24 |
| Last Update Date | 2024-11-28 |