| NPI | 1346750692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 4354) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 021340-1) |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 4354) | |
| Enumeration Date | 2017-10-01 |
| Last Update Date | 2023-03-14 |