| NPI | 1457894511 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-006996) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020430-1) | 
| Enumeration Date | 2016-11-22 | 
| Last Update Date | 2025-06-06 |