| NPI | 1487638227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: SC 925) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 925) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2023-05-31 |