| NPI | 1407438005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NV PA2772) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61157812) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2023-03-09 |