| NPI | 1588913552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3657) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 015809) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2022-07-21 |