| NPI | 1164708111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4994) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 4994) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2023-08-24 |