| NPI | 1902894801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 000709) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2010-04-16 |