| NPI | 1376009399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 023738) |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2021-10-15 |