| NPI | 1780076919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA057485) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA OA003507) |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2024-08-15 |