| NPI | 1356528228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 2921) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00131300) |
| 363AS0400X Physician Assistant, Surgical (Licence: PA MA-052098) | |
| 363A00000X Physician Assistant (Licence: NY 010073) | |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2022-04-15 |