| NPI | 1235566738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 017048) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 3090) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2019-01-28 |