| NPI | 1487977880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5138) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002385) |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2015-03-13 |