| NPI | 1366778623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013531) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3720) |
| Enumeration Date | 2009-10-21 |
| Last Update Date | 2020-12-21 |