| NPI | 1023530342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA200001702) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC TL2763) |
| 363AS0400X Physician Assistant, Surgical (Licence: SC 2763) | |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2023-11-21 |