| NPI | 1689724841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 5389) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 2079) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2026-08-06 |