| NPI | 1265022537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: GA 10179) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10179) |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2023-08-22 |