| NPI | 1306508874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MT 102275) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 102275) |
| Enumeration Date | 2021-10-12 |
| Last Update Date | 2022-02-24 |