| NPI | 1992843908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002129) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011577) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2016-06-09 |