| NPI | 1114178407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601005422) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0003349) |
| Enumeration Date | 2008-10-04 |
| Last Update Date | 2023-07-17 |