| NPI | 1144739798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN 5538) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0745) |
| 363A00000X Physician Assistant (Licence: KY TC656) | |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2024-01-10 |