| NPI | 1245678424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MT 67075) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 23008) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2025-04-10 |