| NPI | 1780120949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 4854) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CT 1486) |
| 363A00000X Physician Assistant (Licence: CT 4854) | |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2020-09-03 |