| NPI | 1558323253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001894) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110010828) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 1894) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2025-05-07 |