| NPI | 1215755269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 6799) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 23.006799) |
| 363A00000X Physician Assistant (Licence: NY 032129) | |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2025-02-11 |