| NPI | 1730797721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 5476) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005304) |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2023-01-31 |