| NPI | 1730709502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101533) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026170) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2025-06-12 |