| NPI | 1356758395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 3128) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA8520) |
| 363A00000X Physician Assistant (Licence: NY 028173) | |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2025-03-12 |