| NPI | 1235930462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 101251) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 033294) |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2025-08-08 |