| NPI | 1851327357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 3868) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9102938) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2019-08-06 |