| NPI | 1376826032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4832) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002559) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2013-10-29 |