| NPI | 1902152960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 002787) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2017-11-06 |