| NPI | 1023846656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 6907) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9119161) |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2025-01-20 |