| NPI | 1407548886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 030405) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2025-08-13 |