| NPI | 1376103812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4561) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 4561) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2022-09-18 |