| NPI | 1720429038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 002859) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002859) |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 002859) | |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2018-10-24 |