| NPI | 1194243899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9829) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: LA 306999) |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2023-12-14 |