| NPI | 1821537770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NH 2011) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3777) |
| 363A00000X Physician Assistant (Licence: MA PA8080) | |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2023-04-25 |