| NPI | 1831740448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 7302-23) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 8592) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2023-05-17 |