| NPI | 1548517584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 3025) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 2821) | |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2025-06-24 |