| NPI | 1447216577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 006894) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001006107) |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 006894) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-05-26 |