| NPI | 1538160593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 000037) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10537) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2016-11-02 |