| NPI | 1891243069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110005488) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-005488) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2024-08-22 |