| NPI | 1972534816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: HI AMD-1070) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MT 436) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-10-08 |