| NPI | 1154754711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL 9109495) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058839) |
| 363A00000X Physician Assistant (Licence: MI 5601011329) | |
| 363A00000X Physician Assistant (Licence: NY 016860) | |
| 363AS0400X Physician Assistant, Surgical (Licence: SC MPA.5834) | |
| 363A00000X Physician Assistant (Licence: NJ 25MP00627300) | |
| 363A00000X Physician Assistant (Licence: VA 0110007964) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MA PA9389) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MO 2023009774) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-13160) | |
| Enumeration Date | 2013-08-18 |
| Last Update Date | 2024-09-05 |