| NPI | 1902118102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 2026) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-02317) |
| 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-02317) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2021-01-25 |