| NPI | 1346998663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 23.006788) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006381) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA064360) | |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2024-12-20 |