| NPI | 1457880049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CT 4214) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant Medical (Licence: CT 4214) | |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2020-11-01 |