| NPI | 1558381582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 5162) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA002308L) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2021-10-05 |