| NPI | 1215661418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008517) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 10004237A) |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2024-09-20 |