| NPI | 1740412915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 3488) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013469) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 003488) | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2023-10-27 |