| NPI | 1780278812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 006713) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026420) |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2024-09-30 |