| NPI | 1427465111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA5051) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 6542) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2026-02-05 |