| NPI | 1639313745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013169) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA64005) |
| 363A00000X Physician Assistant (Licence: CT 5352) | |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2024-02-09 |