| NPI | 1881855120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 103237) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2021-03-02 |