| NPI | 1275163727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 11245) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MS PA00471) |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2022-11-28 |