| NPI | 1528242179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 002037) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA2598) |
| 363A00000X Physician Assistant (Licence: CT 002037) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 002037) | |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2022-05-23 |