| NPI | 1326592015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: VT 055.003151) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TN 3178) |
| 363AS0400X Physician Assistant Surgical (Licence: TN 3178) | |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2022-04-13 |