| NPI | 1447858402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3911) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025679) |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2026-05-29 |