| NPI | 1366200776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 035063) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA17663) |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2026-06-23 |