| NPI | 1568161792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: NE 72) |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-06-08 |