| NPI | 1932979317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA066191) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 031163-01) |
| Enumeration Date | 2024-01-05 |
| Last Update Date | 2025-07-14 |