| NPI | 1073065751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085.006041) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005130) |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2024-01-29 |