| NPI | 1457000333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12130) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-12130) |
| 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-12130) | |
| Enumeration Date | 2022-03-20 |
| Last Update Date | 2023-10-23 |