| NPI | 1659606127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062479) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013636) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2025-10-07 |