| NPI | 1235449638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002418) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 0049093) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2013-06-07 |