| NPI | 1952507915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA 35) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA35) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2023-02-07 |