| NPI | 1235695669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 6043) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 023233) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2024-12-20 |