| NPI | 1063094829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027058) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5388) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2021-12-07 |