| NPI | 1891192092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 018102) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 164119) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2022-01-03 |