| NPI | 1083150411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 3775) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10898) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2022-10-20 |