| NPI | 1497283907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 4724) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022392) |
| 207Q00000X Family Medicine (Licence: CA 54428) | |
| Enumeration Date | 2017-05-28 |
| Last Update Date | 2024-08-23 |