| NPI | 1669000170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4767) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 4767) |
| 363A00000X Physician Assistant (Licence: CT 4767) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2020-04-23 |