| NPI | 1558985416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA062792) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9113181) |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2022-08-22 |