| NPI | 1922382159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: MA PA4598) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106200) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2024-06-06 |