| NPI | 1982034823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017210) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 6317) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00835400) | |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2024-08-01 |