| NPI | 1508974700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.006760RX) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN PA2344) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 009354-1) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2021-04-21 |