| NPI | 1902667876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031378-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA065333) |
| Enumeration Date | 2024-01-18 |
| Last Update Date | 2024-03-28 |