| NPI | 1548686033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12286) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200696) |
| 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-12286) | |
| Enumeration Date | 2014-03-09 |
| Last Update Date | 2023-01-04 |