| NPI | 1285825943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011708) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008700) |
| 363AM0700X Physician Assistant Medical (Licence: CT 1557) | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2024-02-03 |