| NPI | 1760635080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 2772) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012938) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2014-08-28 |