| NPI | 1154953560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7424) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA7424) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2024-08-01 |