NPI | 1235459983 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA3963) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT PA3963) |
Enumeration Date | 2010-06-04 |
Last Update Date | 2024-10-02 |