| NPI | 1578514428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 317) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: SC A317) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2021-08-25 |