| NPI | 1659568079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001791) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012810) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00253600) | |
| Enumeration Date | 2007-09-30 |
| Last Update Date | 2011-03-07 |