| NPI | 1932744620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024293) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 6393) |
| Enumeration Date | 2019-11-17 |
| Last Update Date | 2024-09-23 |