| NPI | 1437775913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 5781) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025098) |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2023-04-11 |