| NPI | 1023294287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002726) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA AP2472) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2015-06-17 |