| NPI | 1093188773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005277) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA2944) |
| 363AS0400X Physician Assistant, Surgical (Licence: TN PA2944) | |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2018-08-15 |