| NPI | 1942983721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 030510) |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2023-10-23 |