| NPI | 1326774282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 6672) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA064125) |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2024-08-19 |