| NPI | 1669986246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA059568) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA OA004379) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2017-11-19 |
| Last Update Date | 2024-02-09 |