| NPI | 1609386028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 030265) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12481) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2025-07-01 |