| NPI | 1982340105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 6902) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 029863) |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2025-03-11 |