| NPI | 1568871283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 017690) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CT 5986) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2023-04-26 |