| NPI | 1982567848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 7422) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 035026) |
| Enumeration Date | 2025-12-08 |
| Last Update Date | 2026-01-13 |