| NPI | 1407297971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA6554) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 002938) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2021-06-28 |