| NPI | 1083099436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: GA 008433) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: MA PA5491) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2022-07-21 |