| NPI | 1730168055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 000102624) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2022-07-21 |