| NPI | 1477848711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DC PA030767) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C04516) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2021-08-12 |