| NPI | 1588187892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 5664) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-1503) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2022-06-29 |