| NPI | 1235505280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7714) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 007714) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2023-03-06 |