| NPI | 1023342656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 23003584) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 12425) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2017-03-31 |