| NPI | 1316513450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 005191) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-05-30 |
| Last Update Date | 2022-09-20 |