| NPI | 1053949354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13855) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA9116654) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-03-26 |