| NPI | 1134511595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 3298) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA5251) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2017-01-30 |