| NPI | 1235724964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031193) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 14195693-1206) |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2025-06-24 |