| NPI | 1265974448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA058602) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA OA003987) |
| Enumeration Date | 2016-11-05 |
| Last Update Date | 2019-02-15 |