| NPI | 1942497938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3671) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: AZ 3671) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2020-08-04 |