| NPI | 1053048090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 5807) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0010167) |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2026-05-14 |