| NPI | 1831230341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA 1193) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA 1193) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2024-01-08 |