| NPI | 1205567898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032998) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA17197) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2025-09-02 |