| NPI | 1346263928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055490) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001382) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2013-02-21 |