| NPI | 1417714999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 6497) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CT 23.006497) |
| Enumeration Date | 2024-03-01 |
| Last Update Date | 2025-11-21 |