| NPI | 1316246382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NH 0825) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA4110) |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2021-11-15 |