NPI | 1114903101 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 336) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000336) |
Enumeration Date | 2005-12-21 |
Last Update Date | 2017-11-03 |