| NPI | 1245480466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5990) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012747) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2025-10-14 |