| NPI | 1114511219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 7011) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026398) |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2025-03-03 |