| NPI | 1649672429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 027435) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA1546) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2025-11-14 |