| NPI | 1225198484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 102315) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0056791) |
| 363A00000X Physician Assistant (Licence: CT 000737) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2015-11-20 |