| NPI | 1881778892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CT 000631) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MA PA8217) |
| 363AM0700X Physician Assistant Medical (Licence: NY 027021) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2025-03-12 |