| NPI | 1942836788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024801) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA064716) |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2025-04-07 |