| NPI | 1053717660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-06802) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C05529) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2023-04-03 |