| NPI | 1831733799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 024377) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 5908) |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2023-02-14 |