| NPI | 1063916328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021929) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 61257) |
| 363A00000X Physician Assistant (Licence: FL 9116005) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2025-08-01 |