| NPI | 1114910247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN 1120) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1120) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2023-11-20 |