| NPI | 1881942142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 2898) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 2898) |
| 363A00000X Physician Assistant (Licence: MA PA4507) | |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2019-10-09 |