| NPI | 1861672842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01063) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 001001063) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2021-05-11 |