| NPI | 1326470519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 0007061) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 016712) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2022-04-20 |