| NPI | 1134393416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CT 3153) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CT 7538) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2017-01-12 |