| NPI | 1710326491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 4125) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 016738) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2020-04-15 |