| NPI | 1750797239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 006058) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05209) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2023-12-13 |