| NPI | 1407043789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: SC 4461) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC MLA1250) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2024-01-16 |