| NPI | 1831315738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 2077) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030374) |
| 363A00000X Physician Assistant (Licence: CT 002077) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2012-03-13 |