| NPI | 1477736932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 23012323) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA7855) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 5189) | |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2025-04-09 |