| NPI | 1477382836 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032147)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0009956)  | 
| Enumeration Date | 2024-08-01 | 
| Last Update Date | 2025-08-12 |