| NPI | 1346929403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032614) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 14276052-1206) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2026-05-19 |