| NPI | 1679932784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3532) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VT 055-0031493) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2021-05-06 |