| NPI | 1518919331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 1767) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 1767) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2022-10-26 |