| NPI | 1700202793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009293) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0110009293) |
| 363AS0400X Physician Assistant, Surgical (Licence: MA PA4954) | |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2023-08-21 |