| NPI | 1275721334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA2393) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 2393) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2023-09-22 |