| NPI | 1073761904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 012646) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002198) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2008-12-08 |