| NPI | 1881178960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: 7153) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 7153) |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2023-07-13 |