| NPI | 1598954208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA1051) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002021) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2021-05-12 |