| NPI | 1356005474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 034209) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8728) |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2025-11-10 |