| NPI | 1417176132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: LA A10436) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MS PA 037) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2023-09-14 |