| NPI | 1922293141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 016955-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1336) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2025-03-03 |