| NPI | 1497928931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 3649) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 3649) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 013905) | |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2022-10-12 |