| NPI | 1841953015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 5427) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: CT 5427) |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2022-05-04 |