| NPI | 1487821401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 2234) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011301) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2023-01-31 |