| NPI | 1902811771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017430-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00126700) |
| 363A00000X Physician Assistant (Licence: SC 4969) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2025-09-15 |