| NPI | 1396055000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 2490) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CT 2490) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2020-10-12 |