| NPI | 1689333429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101474) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5321) |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2025-05-12 |