| NPI | 1043346992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 001885) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003362) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2010-07-27 |