| NPI | 1043685613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 7882) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 007882) |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2020-10-21 |