| NPI | 1568937738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA102291) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9114509) |
| 363A00000X Physician Assistant (Licence: NY 022653) | |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2026-05-20 |