| NPI | 1235394388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 012641) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 6027) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 23012641) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 012641) | |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2025-08-08 |