| NPI | 1891355459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007294) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023631) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2020-03-23 |