| NPI | 1972077279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 023025) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4342) |
| Enumeration Date | 2019-01-20 |
| Last Update Date | 2019-03-05 |