| NPI | 1447627054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 3416) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001922A) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2019-11-12 |