| NPI | 1598018723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000861) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: DE C5-T000121) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2022-01-18 |