| NPI | 1457405524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 7128) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 011033-1) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2025-09-29 |