| NPI | 1295341618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061504) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025655) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2026-02-03 |