| NPI | 1306159470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-05393) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-003825) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2021-03-31 |