| NPI | 1922590561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 110551) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 5315) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2022-08-01 |