| NPI | 1902590573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NY 435239) |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-06-06 |