| NPI | 1972162840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 6004) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2024-03-22 |