| NPI | 1992345581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA7354) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 7269) |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2025-10-30 |