| NPI | 1154895332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 9193) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: GA 9193) | |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2023-04-11 |