| NPI | 1669851499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MO 2015020790) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2024-09-12 |