| NPI | 1558529255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 002741) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA051343) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2014-10-21 |