| NPI | 1922205392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2156) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 2156-023) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2021-03-31 |