| NPI | 1427077502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 1788) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA 2151) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 1788) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2010-05-04 |