| NPI | 1376952358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017752) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA01790) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2025-10-22 |