| NPI | 1952853095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DC PA031304) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC 031304) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2022-12-15 |