| NPI | 1013673649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 028775) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063220) |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2026-01-02 |