| NPI | 1427294313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: GA 007537) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5049) |
| 363AS0400X Physician Assistant Surgical (Licence: MD C0003872) | |
| 363A00000X Physician Assistant (Licence: PA MA061772) | |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2022-06-03 |