NPI | 1871070219 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4143) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4143) |
Enumeration Date | 2018-07-27 |
Last Update Date | 2019-04-23 |