| NPI | 1366818254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 3447) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 5790) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2025-12-15 |