| NPI | 1770988214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA-057295) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MA-057295) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2022-10-10 |