| NPI | 1730729120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: VA 0110007785) | |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2022-03-07 |