| NPI | 1780617928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 5196) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 011345) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2024-11-05 |