| NPI | 1538267869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0003778) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 08621) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-07-20 |