| NPI | 1013428705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA9317) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059268) |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2024-06-06 |