| NPI | 1396858726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA2376) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001777) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2019-12-06 |