| NPI | 1063726271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SD 0758) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 615) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2022-05-09 |