| NPI | 1417570722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4917) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4917) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2024-05-13 |