| NPI | 1023547585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-07529) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-01-14 |