| NPI | 1740794106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 004006) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4006) |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2021-06-10 |