| NPI | 1154870665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 3693) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2020-09-24 |