| NPI | 1942676804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3639) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 3639-23) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2020-11-09 |