| NPI | 1811478167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 022612) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA67120) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2026-04-20 |