| NPI | 1851517130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: MO 2007005971) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2007005971) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2024-09-12 |