| NPI | 1073756151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 2725) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 101528) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2024-04-12 |