| NPI | 1558808378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031196) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3768) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2025-07-16 |