| NPI | 1669122099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3638) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA063485) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2024-12-03 |