| NPI | 1386707545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00585) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-00585) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2021-10-22 |