| NPI | 1184076994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C0006737) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005395) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2021-08-21 |