| NPI | 1710141403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5621) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012612) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2026-05-15 |