| NPI | 1205347259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021556) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2025-07-27 |