| NPI | 1184049959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: AZ 5664) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006954) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2024-02-13 |