| NPI | 1295974889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA060769) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA #3240) |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2021-06-10 |