| NPI | 1003922345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 000840) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 000840) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2013-12-12 |