| NPI | 1659581577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7388) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002166) |
| 363A00000X Physician Assistant (Licence: IL 085-002297) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2023-10-30 |