| NPI | 1770555195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00313) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 1000313) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2023-06-26 |