| NPI | 1104898436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 52744) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 001399) |
| 208800000X Urology (Licence: CT 52744) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2021-01-15 |