| NPI | 1386300325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA063028) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063028) |
| 363A00000X Physician Assistant (Licence: PA OA005954) | |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2023-04-20 |