| NPI | 1568847564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-05806) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2023-02-15 |