| NPI | 1841492089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 002050) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002050) |
| 363A00000X Physician Assistant (Licence: NY 012088) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2019-10-15 |