| NPI | 1538582507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 6888) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017277) |
| 363A00000X Physician Assistant (Licence: NV PA2143) | |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2025-01-16 |