| NPI | 1023461605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA6156) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3627) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 3627) | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2024-11-27 |