| NPI | 1730605486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56613) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 021117) |
| 363A00000X Physician Assistant (Licence: NY 021117) | |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2026-07-24 |