| NPI | 1285396341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: PA OA005765) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA OA005765) |
| 363AM0700X Physician Assistant Medical (Licence: PA MA062686) | |
| 363AS0400X Physician Assistant Surgical (Licence: PA MA062686) | |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2021-10-06 |