| NPI | 1316066186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0000442) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053769) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2021-07-02 |