| NPI | 1790319655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4782) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 8063-23) |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2025-09-26 |