| NPI | 1427230804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CT 2035) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CT 002035) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2015-01-14 |