| NPI | 1750447355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA975) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 1189) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2024-07-08 |