| NPI | 1760822589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: DC sa0185) |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: LA 124157) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2020-06-13 |