| NPI | 1225761653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032558) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 6737) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-07-04 |
| Last Update Date | 2024-09-10 |