| NPI | 1467006528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA9555) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 5117) |
| Enumeration Date | 2019-07-27 |
| Last Update Date | 2023-11-07 |