| NPI | 1013195551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3806) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0002509) |
| 363AM0700X Physician Assistant, Medical (Licence: DC PA031111) | |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2025-03-15 |