| NPI | 1659445955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086H0002X Surgery, Hospice and Palliative Medicine (Licence: MD C05185) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 001287) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2019-12-30 |