| NPI | 1487626255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 003861) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000942) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2016-09-30 |