| NPI | 1437193901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA630) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 630) |
| 363A00000X Physician Assistant (Licence: CT 002914) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-04-04 |