| NPI | 1932715760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061861) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MA061861) |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-12-02 |