| NPI | 1932695905 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 022191)  | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical | 
| Enumeration Date | 2018-07-02 | 
| Last Update Date | 2022-04-15 |