| NPI | 1336293240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00778) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NC 001000778) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2023-05-31 |