| NPI | 1750003000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 030207) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA 1181266) |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2026-02-11 |