| NPI | 1366176372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 006848) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA8779) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2025-08-04 |