| NPI | 1255660247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3077) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 005657) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085004279) | |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2015-06-26 |