| NPI | 1790918415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY .....) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA64374) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2025-10-06 |