| NPI | 1467544122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 5043) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1790) |
| 363A00000X Physician Assistant (Licence: NY 016534-1) | |
| 363A00000X Physician Assistant (Licence: MA AP2224) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2021-03-10 |