| NPI | 1699088336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 014109) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002610) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2024-05-15 |