| NPI | 1376609057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 001138) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001138) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2022-09-15 |