| NPI | 1205330156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 4425) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021904-1) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2022-10-05 |