| NPI | 1902509904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 11812) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-09-11 |