| NPI | 1497099154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 3570) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018620-1) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2016-08-20 |