| NPI | 1285149005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 023780) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 23.004041) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2020-11-10 |