| NPI | 1619944766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000366) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2018-09-05 |