| NPI | 1760876304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 10908) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DC PA031109) |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2022-04-14 |