| NPI | 1952767170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DC PA200001211) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019302-1) |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2023-11-20 |