| NPI | 1710138524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 6155) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 012846) |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2023-11-09 |