| NPI | 1548593643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 3237) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9108403) |
| 363A00000X Physician Assistant (Licence: MA PA3809) | |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2022-01-26 |