| NPI | 1043853989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: DC PA031699) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2024-02-08 |