| NPI | 1477195089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: MA PA7234) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: PA7234) |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2019-11-05 |