| NPI | 1629386768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9918) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013862) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 013862) | |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2025-03-17 |