| NPI | 1043686637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 005411) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 9272) |
| 235Z00000X Speech-Language Pathologist, (Licence: CT 004501) | |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2021-09-19 |