| NPI | 1992902977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 003326) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8042) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-11-20 |