| NPI | 1508194143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 2861) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA054142) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2024-10-03 |