| NPI | 1881944676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 016012) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 016012) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2022-10-18 |