| NPI | 1942365986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 008489) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5545) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2022-05-07 |