| NPI | 1962979187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 025100) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 25100) |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2023-07-03 |