| NPI | 1013327451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 003473) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 003473) |
| 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00328600) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 003473) | |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2016-01-11 |