| NPI | 1477960045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 003138) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3138) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2023-01-26 |