| NPI | 1407302920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5843) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 003647) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2024-10-31 |