| NPI | 1396795274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 3699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA 052468) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2021-08-19 |