| NPI | 1982268132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9111985) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 66037) |
| 363A00000X Physician Assistant (Licence: NY 027949) | |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2026-01-28 |