| NPI | 1053605014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: C5-0011882) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MA053609) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2023-05-01 |