| NPI | 1154179190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5955) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 034526) |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2025-09-26 |