| NPI | 1790037497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7172) |
| 363A00000X Physician Assistant (Licence: NY 23 016123) | |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2026-04-14 |