| NPI | 1942872767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009251) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027165) |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2025-07-28 |