| NPI | 1235604281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 4291) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6766) |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2024-02-16 |