| NPI | 1821769555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 6699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027187) |
| 363A00000X Physician Assistant (Licence: CT 6699) | |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2024-09-19 |