| NPI | 1114977915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10000701A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1783) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2024-11-05 |