| NPI | 1558765982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 036063) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005873) |
| 363A00000X Physician Assistant (Licence: PA MA057215) | |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2026-07-22 |