| NPI | 1518983972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010642) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00117600) |
| 363A00000X Physician Assistant (Licence: CT 5906) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2023-01-27 |