| NPI | 1083845226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 2390) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA3807) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2021-05-19 |