| NPI | 1437635158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059918) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: 0000000) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2024-02-01 |