| NPI | 1316543697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001010667) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 001010667) |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2023-02-01 |