| NPI | 1255578027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002818) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013055-1) |
| 363A00000X Physician Assistant (Licence: FL 9104104) | |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2013-06-23 |