| NPI | 1265628739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 003152) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 002951-1) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2015-04-12 |