| NPI | 1396515094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 6436) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-01-03 |
| Last Update Date | 2024-03-06 |