| NPI | 1558438119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08828) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA 725) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2021-09-20 |