| NPI | 1629494364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 001010811) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA107723) |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2022-06-30 |