| NPI | 1871769166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3035) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021544) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2019-02-13 |