| NPI | 1891922431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA1060) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 001512) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2020-09-22 |