| NPI | 1922732999 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032368) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00867100) | 
| Enumeration Date | 2022-07-14 | 
| Last Update Date | 2025-04-17 |