| NPI | 1760513014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000783) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2014-03-04 |