| NPI | 1336559517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: GA 007193) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 007193) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2020-10-20 |