| NPI | 1598910697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CT 000515) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CT MS1653422) |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2008-11-18 |