| NPI | 1215007919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001802) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: CT L-68965) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2022-11-07 |