| NPI | 1245563089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C06667) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI LL007041) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2024-10-07 |