| NPI | 1205754975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 035604) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9121797) |
| Enumeration Date | 2026-07-08 |
| Last Update Date | 2026-07-08 |