| NPI | 1114434255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-07795) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.1500) |
| 363A00000X Physician Assistant (Licence: NC 001017795) | |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2023-08-01 |