| NPI | 1669841805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5902) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 062136) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2023-07-16 |