| NPI | 1821546607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3699) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 3699) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2019-09-29 |