| NPI | 1720069552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2386) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001243) |
| 363AM0700X Physician Assistant Medical (Licence: CT 001243) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2024-04-30 |