| NPI | 1548508310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04040) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-04040) |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2021-03-30 |