| NPI | 1033667688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 388623) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 3886-23) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2022-01-24 |