| NPI | 1184822777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4962) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012414) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2025-02-01 |