| NPI | 1548651805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 018427) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 03280) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2018-07-12 |