| NPI | 1184110660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 022288) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 4158) |
| Enumeration Date | 2018-07-08 |
| Last Update Date | 2018-08-30 |