| NPI | 1629180229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 004534) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 1067363) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-12-07 |