| NPI | 1538519202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA058357) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA OA003845) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2023-12-26 |