| NPI | 1851312532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 000041) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 03555) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2013-09-10 |