| NPI | 1568454437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 006742) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 6742) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2025-06-27 |