| NPI | 1245781467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8099) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020125) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2025-08-18 |