| NPI | 1629499157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4629) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056624) |
| 363AM0700X Physician Assistant, Medical (Licence: MA PA100535) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 031855) | |
| Enumeration Date | 2013-12-31 |
| Last Update Date | 2025-03-12 |