| NPI | 1811454176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11993) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023150) |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2026-04-14 |