| NPI | 1164796009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 008438) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061645) |
| 363A00000X Physician Assistant (Licence: GA 004588) | |
| 363A00000X Physician Assistant (Licence: NJ 25MP00040500) | |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2025-08-20 |