| NPI | 1316509441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 027240) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 4541) |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2022-06-17 |