| NPI | 1952362048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2009017044) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: KS 1500845) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2019-04-23 |