| NPI | 1407497324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA061011) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
| 363AS0400X Physician Assistant Surgical (Licence: PA OA004992) | |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2022-03-01 |