| NPI | 1700137031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 2185) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2185) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2022-08-29 |