| NPI | 1295841922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4935) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: MO 2000174355) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2024-08-09 |