| NPI | 1588067417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 018068) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5519) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2021-12-20 |