| NPI | 1962576892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 2183) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 2091) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2025-09-22 |