| NPI | 1114514163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026140) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 207R00000X Internal Medicine (Licence: NY 026140) | |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2025-11-18 |