| NPI | 1477007540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019815) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 003837) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 0198151) | |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2025-08-26 |