| NPI | 1740391051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 3553) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: GA 3553) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-01-25 |