| NPI | 1982152773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 23020150) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5018) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2020-11-02 |