| NPI | 1013794692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 034281) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA17190) |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2025-11-26 |