| NPI | 1750803037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 3897) |
| Enumeration Date | 2017-07-08 |
| Last Update Date | 2021-08-13 |