| NPI | 1013238559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4226) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 017215) |
| 363AM0700X Physician Assistant, Medical (Licence: MD c0004200) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2018-09-14 |