| NPI | 1093944498 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06691) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013333) | 
| 363AM0700X Physician Assistant, Medical (Licence: MD C0006691) | |
| Enumeration Date | 2009-07-07 | 
| Last Update Date | 2025-07-17 |