| NPI | 1851450902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA8877) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 003325) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2022-10-07 |