NPI | 1629506092 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3870) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-05-30 |
Last Update Date | 2019-10-02 |