| NPI | 1043732316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: VA 0110005629) |
| Enumeration Date | 2017-07-08 |
| Last Update Date | 2023-01-24 |