| NPI | 1548254774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 000766) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 003558) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2014-04-17 |