| NPI | 1912986829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN 793) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2024-05-16 |