| NPI | 1831222462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0006012) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 005702-1) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2025-06-23 |