| NPI | 1497811251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5087) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: AZ 5087) |
| 363A00000X Physician Assistant (Licence: MD C02420) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2021-06-07 |