| NPI | 1902913445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CT 000192) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 00192) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2013-12-23 |