| NPI | 1609642164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 031884) |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2026-08-14 |