| NPI | 1831925601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 23.006771) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-19 |