| NPI | 1730455759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 006609) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015436) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2025-10-22 |