| NPI | 1306217211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 5417) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0001027) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2021-12-06 |