| NPI | 1316911464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA OA002190) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA ma003282l) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2023-12-21 |