| NPI | 1154808053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C00006851) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2021-11-09 |