| NPI | 1891382651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 026060) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA062042) |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2020-12-28 |