| NPI | 1194493189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032208) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 60771) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2025-03-21 |