| NPI | 1376707935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052871) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000556) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2008-07-14 |