| NPI | 1457696890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 002809) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2021-06-29 |