| NPI | 1952889560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 022318) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 022318) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2019-01-02 |