| NPI | 1295207413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4392) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 4392) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2019-11-12 |