| NPI | 1285153627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 030719-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062536) |
| 363A00000X Physician Assistant (Licence: CT 3963) | |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2024-02-01 |