NPI | 1154561884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002236) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013444) |
363A00000X Physician Assistant (Licence: MA PA7540) | |
Enumeration Date | 2009-02-20 |
Last Update Date | 2025-03-12 |