| NPI | 1578085049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA17452) |
| 363A00000X Physician Assistant (Licence: NY 021259) | |
| Enumeration Date | 2017-07-16 |
| Last Update Date | 2025-04-09 |