| NPI | 1184940264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003243) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110003243) |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2022-07-21 |