| NPI | 1184956690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 2348) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 002348) |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2018-03-17 |