| NPI | 1316344633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601009145) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004941) |
| 363A00000X Physician Assistant (Licence: IL 085005347) | |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2022-07-25 |