| NPI | 1477226991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA062672) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OA005722) |
| 363A00000X Physician Assistant (Licence: PA OA005722) | |
| 363AS0400X Physician Assistant Surgical (Licence: PA OA005722) | |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2024-07-09 |