| NPI | 1083242283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CT 5384) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2021-09-23 |