| NPI | 1114228251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 3094) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105547) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2014-07-22 |