| NPI | 1114032315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA 1296) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA 1296) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2023-03-27 |