| NPI | 1194053215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 003451) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CT 000929) |
| 363A00000X Physician Assistant (Licence: CT 003451) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 003451) | |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2015-10-09 |