| NPI | 1952805749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: TN 3534) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2018-06-25 |