| NPI | 1558609578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C06499) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110004796) |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2024-04-08 |