| NPI | 1154919561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA209821) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085008846) |
| Enumeration Date | 2021-01-02 |
| Last Update Date | 2022-07-11 |