| NPI | 1649861683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11129) |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2025-05-28 |