| NPI | 1336887033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13339) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9116313) |
| 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-13339) | |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2024-08-13 |