| 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 |