| NPI | 1114007424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 4849) |
| Additional Taxonomies | 208800000X Urology (Licence: GA 4849) |
| 363A00000X Physician Assistant (Licence: GA 004849 - PA) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2022-05-10 |