| NPI | 1144768466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 033601) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058716) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2025-04-10 |