| NPI | 1760908438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06560) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD C06560) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2024-07-24 |