| NPI | 1760848741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-06155) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 0010-06155) |
| 363A00000X Physician Assistant (Licence: NC 0010-06155) | |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2023-06-20 |