| NPI | 1942896808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025976) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA064752) |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2023-09-04 |