| NPI | 1912531070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 4906) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: CT 4906) | |
| 363AM0700X Physician Assistant, Medical | |
| 363AM0700X Physician Assistant, Medical (Licence: CT 4906) | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2023-06-01 |