| NPI | 1043681679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027847) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0005890) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2026-03-16 |