| NPI | 1942379813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 001757) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001757) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2013-06-06 |