| NPI | 1023174968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 008751) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001856) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2014-11-10 |