| NPI | 1689690687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001778) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 006069-1) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-08 |