| NPI | 1649280587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 03333) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 18230) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2019-02-26 |