| NPI | 1295774891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA003067L) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA003067L) |
| 363A00000X Physician Assistant (Licence: MD C0002427) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-03-07 |