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NPI Profile for GINA RUPERT in SOUTHBURY, CT.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant |
| NPI # | 1184652711 |
|
| Status | Active | |
| Credentials | PAC | |
| Entity | Individual | |
| Enumeration date | 06/30/2006 | |
| Last updated | 10/28/2021 - About 5 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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GINA RUPERT
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GINA RUPERT, PAC