| NPI | 1427048412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001455) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110001442) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2007-07-08 |