| NPI | 1144244369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052082) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: PA MA052082) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-10-08 |