| NPI | 1407132459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002666) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5923) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2022-01-25 |