| NPI | 1881898708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011140) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00160600) |
| 363A00000X Physician Assistant (Licence: CT 002260) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2021-12-21 |