| NPI | 1699329375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9112341) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2020-02-03 |