| NPI | 1558885772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA059156) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 034383) |
| Enumeration Date | 2017-07-30 |
| Last Update Date | 2025-09-30 |