| NPI | 1194094300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017284) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA101990) |
| 363AM0700X Physician Assistant, Medical (Licence: NY P82149) | |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2025-08-25 |