| NPI | 1174226310 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-13147)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 0010-13147)  | 
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NC 0010-13147)  | |
| 363A00000X Physician Assistant (Licence: NC 0010-13147)  | |
| Enumeration Date | 2023-03-27 | 
| Last Update Date | 2024-04-15 |