| NPI | 1033738166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CT 5185) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 5185) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2025-07-31 |