| NPI | 1497085526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA054280) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 003736) |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 003736) | |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2020-12-18 |