| NPI | 1033525068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA056930) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA OA003316) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2024-10-15 |