| NPI | 1487282133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-15522) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025636) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-07-29 |