| NPI | 1033736970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: MA PA7717) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4980) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2023-11-19 |