| NPI | 1467426619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA1068) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00948) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2024-06-06 |