| NPI | 1215331145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 4757) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018060) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2024-07-16 |