| NPI | 1972735363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2487) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: WI 2487-23) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2019-09-12 |