| NPI | 1699116582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 3265) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 016678) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 3265) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2022-08-10 |