| NPI | 1003001587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 3091) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 012657) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2023-01-24 |