| NPI | 1700133402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 002209-1) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2025-06-05 |