| NPI | 1235775438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 10160) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9112791) |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2021-02-08 |