| NPI | 1528333192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: HI AMD490) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AS0400X Physician Assistant, Surgical (Licence: FL 9106513) | |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2021-06-03 |