| NPI | 1134376304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012667) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2016-08-23 |