| NPI | 1457446874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 01738) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CT 01738) |
| 363AS0400X Physician Assistant Surgical (Licence: CT 01738) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2024-03-25 |