| NPI | 1487646287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 3264) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 3264) |
| 364SM0705X Clinical Nurse Specialist, Medical-Surgical (Licence: GA 003264) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2022-02-22 |