| NPI | 1982234761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062659) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024613) |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2022-01-26 |