| NPI | 1730181355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA1543) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001341) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2025-04-21 |