| NPI | 1619207156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-02408) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2023-03-24 |