| NPI | 1083949754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 2525) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013516) |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 002525) | |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2018-04-03 |