| NPI | 1497035208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 6784) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 6784) |
| 363A00000X Physician Assistant (Licence: RI PA00704) | |
| 363A00000X Physician Assistant (Licence: MA PA4688) | |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2025-10-09 |