| NPI | 1356713945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019196) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA8156) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2025-11-12 |