| NPI | 1184098832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: GA 9782) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: SC 2476) |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2024-02-26 |