| NPI | 1811996291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MD C0001915) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: MD C0001915) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2020-10-06 |