| NPI | 1548631096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 6171) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA181101) |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2019-10-22 |