| NPI | 1932684974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 4257) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022600) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00578000) | |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2023-09-19 |