| NPI | 1417475641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 7173) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3954) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2022-02-22 |