| NPI | 1831814631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 034107) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA064045) |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2025-09-30 |