| NPI | 1952959546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 5026) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023926) |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2020-10-29 |