| NPI | 1801340344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 6096) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3061) |
| Enumeration Date | 2016-08-13 |
| Last Update Date | 2023-08-04 |