| NPI | 1144692328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 4599) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2023-03-20 |