| NPI | 1992472450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 23.005339) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 5339) |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2022-06-22 |