| NPI | 1659541688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: IA 001889) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: SD 0936) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2023-08-18 |