| NPI | 1518434422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 004315) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4315) |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2021-02-21 |