| NPI | 1326535162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031099) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4060) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2024-01-26 |