NPI | 1831637693 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3769) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3769) |
Enumeration Date | 2017-02-01 |
Last Update Date | 2017-02-14 |