| NPI | 1558745091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021222) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3381) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2024-04-12 |