| NPI | 1487166211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA06434) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WV 2828) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2022-07-11 |