| NPI | 1326634551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 10122) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10122) |
| 363AS0400X Physician Assistant, Surgical | |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 10122) | |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2023-09-12 |