| NPI | 1740718105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4078-23) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2022-12-27 |