| NPI | 1093882540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 5594) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 15866) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2022-03-11 |