| NPI | 1871192252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 025413) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 025413) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 025413) | |
| Enumeration Date | 2020-10-18 |
| Last Update Date | 2022-02-23 |