| NPI | 1639408982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001348) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 007634) |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2013-07-09 |