| NPI | 1154561884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002236) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013444) |
| 363A00000X Physician Assistant (Licence: MA PA7540) | |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2025-03-12 |