| NPI | 1699228353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 5193) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5939) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2023-11-09 |