| NPI | 1578914479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 112238) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IA 082951) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2023-01-30 |