| NPI | 1821321266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9105438) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013493) |
| 363A00000X Physician Assistant (Licence: CT 2311) | |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2013-03-22 |