| NPI | 1801220207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 003098) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4780) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 003098) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 003098) | |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2024-02-13 |