| NPI | 1891499323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 3168349) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1207141) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2025-03-04 |