| NPI | 1598786923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 0761) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 001364) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2018-09-05 |