| NPI | 1083128730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: UT 9888137-4810) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2021-12-27 |