| NPI | 1427788009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 5717) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: RI PA01468) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2024-01-04 |