| NPI | 1730329202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000648) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE CS-0000648) |
| 363AS0400X Physician Assistant Surgical (Licence: NY 013645) | |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2021-03-15 |