| NPI | 1952705071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 018170) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 003743) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 018170) | |
| 363A00000X Physician Assistant (Licence: CT 003743) | |
| 363A00000X Physician Assistant (Licence: NY 018170) | |
| 363A00000X Physician Assistant (Licence: TX PA14874) | |
| 363AM0700X Physician Assistant, Medical (Licence: CT 003743) | |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2021-11-16 |