| NPI | 1689765943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 1053) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000880) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-01-30 |