| NPI | 1285765230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NH 1460) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 000411) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 004229) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2019-04-23 |