| NPI | 1366043077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PR 001726) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9626530) |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant | |
| 363A00000X Physician Assistant (Licence: FL TPPA596) | |
| Enumeration Date | 2020-11-08 |
| Last Update Date | 2024-04-07 |