| NPI | 1952187841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 033594) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 11949) |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2025-08-12 |