| NPI | 1992167878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-08081) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 53267) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2021-07-29 |