| NPI | 1083281067 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 6948) | 
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical | 
| Enumeration Date | 2021-06-08 | 
| Last Update Date | 2025-04-09 |