| NPI | 1770547333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 1388) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 100129) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2023-10-24 |