| NPI | 1275102808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA062695) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 032738) |
| 363A00000X Physician Assistant (Licence: PA MA062695) | |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2025-07-21 |