| NPI | 1669806832 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C06095) | 
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical | 
| Enumeration Date | 2013-08-23 | 
| Last Update Date | 2020-03-31 |