| NPI | 1831154962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: PA OA006610) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MA052121) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2023-09-14 |