| NPI | 1295926608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 001423) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 1718) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2015-10-09 |