| NPI | 1689641722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 7023) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009909) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2026-01-28 |