| NPI | 1356382147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CT 1924) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001000962) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2024-05-22 |