| NPI | 1003391905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AL PA.1238) |
| Additional Taxonomies | 2086S0129X (Licence: AL PA.1238) |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2023-07-19 |