| NPI | 1962682252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA2441) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA AP2441) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2023-02-14 |