| NPI | 1124855119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 033357) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2025-07-17 |