| NPI | 1104889765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AL PA.478) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103178) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2023-04-11 |