| NPI | 1881733103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001391) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 007274-1) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2010-12-02 |