| NPI | 1275047409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ID PA-1640) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 3472) |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2023-08-01 |