| NPI | 1750324356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CT 002112) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002112) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-12-10 |