| NPI | 1013578467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4727-23) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2024-10-18 |