NPI | 1598765711 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001072) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA1264) |
Enumeration Date | 2005-07-29 |
Last Update Date | 2013-06-28 |