NPI | 1760635080 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 2772) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012938) |
Enumeration Date | 2008-10-30 |
Last Update Date | 2014-08-28 |