| NPI | 1033185087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 000984) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103479) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2020-06-18 |