| NPI | 1982895397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011897) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12764) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2026-03-26 |