| NPI | 1790823078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 3220) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002920) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2021-06-02 |