| NPI | 1790109478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 5319) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085004970) |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2022-03-22 |