| NPI | 1831368281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002117) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011034) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2009-01-16 |