| NPI | 1841608551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IA 074713) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 15189) |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2025-01-07 |