| NPI | 1134519606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD CO5688) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C05688) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2022-04-07 |