| NPI | 1245740422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9114793) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL 9114793) |
| 207X00000X Orthopaedic Surgery (Licence: TN 3406) | |
| 363A00000X Physician Assistant (Licence: TN 3406) | |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2022-01-20 |