| NPI | 1912638529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031109) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.008530RX) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2025-10-21 |