| NPI | 1114273760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 2930-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2930) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2021-11-01 |