| NPI | 1669079034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110008272) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0110008272) |
| 363A00000X Physician Assistant (Licence: NC 0010-11117) | |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2023-10-25 |