| NPI | 1922553312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA9527) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NH 1189) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2024-03-25 |