| NPI | 1396216578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031154-01) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2025-08-11 |