| NPI | 1750860599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001008346) |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2021-06-25 |