| NPI | 1396461646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032971) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC PA4638) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2026-03-18 |