| NPI | 1245203397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NV PA1786) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 007274) |
| 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-03118) | |
| 363AS0400X Physician Assistant, Surgical (Licence: OH 50.001903) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-08-28 |