| NPI | 1720588049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 8884) |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2023-10-31 |