| NPI | 1497283907 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 4724)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 54428)  | 
| 363A00000X Physician Assistant (Licence: NY 022392)  | |
| Enumeration Date | 2017-05-28 | 
| Last Update Date | 2024-11-13 |