| NPI | 1891251088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 4404) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023263) |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2021-06-30 |