| NPI | 1730911355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032308) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9119048) |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2025-05-01 |